Association between three non-insulin-based indexes of insulin resistance and hyperuricemia.

Objective: The association between hyperuricemia and insulin resistance (IR) has been demonstrated by many studies, but the traditional IR indexes are too impractical to be used in clinical practice for the recognition of the IR state in individuals with hyperuricemia. Therefore, we aimed to further investigate the association between hyperuricemia and three non-insulin-based IR indexes in this large-scale cross-sectional study.

Methods: A total of 174,695 adults without self-reported use of antihyperuricemic agents, hypoglycemic agents, or lipid-lowering drugs were included in the current analysis. The triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc), the product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS-IR) were calculated. Then, logistic regression analyses were applied to explore their association with hyperuricemia.

Results: The TG/HDLc, TyG, and METS-IR all had positive correlations with uric acid level. However, only TG/HDLc and TyG were significantly associated with hyperuricemia in both sexes and body mass index (BMI) classification (the ORs of the highest quartile for each were 6.751 and 1.505 in females and 6.487 and 1.646 in males, respectively). The AUC values of TG/HDLc and TyG to discriminate hyperuricemia were also statistically significant in both sexes and BMI classification (all greater than 0.7).

Conclusions: TG/HDLc and TyG are strongly associated with hyperuricemia regardless of BMI classification. These two obtainable and cost-effective non-insulin-based IR indexes could be potential monitors during the management of hyperuricemia and prevention of its IR-driven comorbidities. Key Points • In this large-scale study, we identified TG/HDLc and TyG as indicators for identification of IR in patients with hyperuricemia. • These simple and practical IR indicators are of substantial clinical importance for implementing preventive strategies against IR-driven comorbidities of hyperuricemia.